172725 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: 00350837 Page 1 of 1
ONE CIVIC SQUARE ATLAS RESTAURANT SUPPLY
CARMEL, INDIANA 46032 PO BOX 4075 CHECK AMOUNT: $2,511.48
SOUTH BEND IN 46634-4075
CHECK NUMBER: 172725
CHECK DATE: 5/27/2009
D EPARTMENT AC COUNT PO NUM BER INVOICE NUMBER AMOUN DESCR
1207 4463000 730838 2,511.48 FURNITURE FIXTURES
•f
52245 STATE RD. 933 NORTH:. 2244 S. DIVISION
'SOUTH BEND, IN 46637 GRAND RAPIDS, MI 49507 RESTAURANT SUPPLY NO. 708
(574) 272 3343 2 -8
1- 800 -552 -ATLAS (616) 248 -2888 1 -800- 49527 ATLAS 3,
RESTAURANT SUPPLY. P.O. BOX 4075
3329 N. SHADELAND AVE. 929 N. COLISEUM SOUTH BEND, IN 46634 -4075 1
INDIANAPOLIS, IN 46226 FORT WAYNE,.IN 46805
FOOD SERVICE EQUIPMENT_ &'SUPPLIES (317) 541 -1111 1 -800- 333 -2001 (260) 1- 866 -467 -1788
05/04/09
206230 01
CITY OF CARMEL dha BROOKSHIRE GOLF CLUB
BROOKSHIRE GOLF CLUB 12120 BROOKSHIRE PARKWAY
1 CIVIC SQUARE CARMEL IN 460.33
ICARMEL, IN 46032
REFERENCE NUMBER SHIP DATE SALESPERSON FREIGHT SHIP VIA
I PAM LTSTER 05/04.%09 21 STEVE. BEAT NET 30 ZG 389188.0'8 PREPAID FACTORY DIRECT
ITEM DESCRIPTION
US'74103.7 GROSILLEX TABLE 48 "tRD 000 2.000 .000 EA 170.59 EA 341.18
SEDONA BRONZE, MIST
1,
CT 1 29037 GROSF ILLEX SLING CHAIR 14. 000 14. 000 000 EA 112. 75 EA 1578. 50
KHAKI SLING/BRONZE-MIST FRAME
US701037 GROSF I LLEX TABLE S I ENA. '32' SQ 2.'000 n. 000 .000 .EA 130.25 EA 260.50
BRONZE MIST
98602117 GROSFTLL_EX UMBRELLA.BASE 4.000 4.000 000 EA 35.96 EA 143. 8A
BLACI'.
SH SHIPPING HANDLING 1.000 1.000. .000 EA 187. '46 EA 187.4
MISCELLANEOUS MERCHANDISE 0
rURITY AGREEMENT. Purchaser hereby. grants and conveys to Seller a ik
in the goods described above and their proceeds pursuant to the y o
stained on the reverse side of this document.
2324. 027 187. 46 .00 00 i
CUSTOMER.COf
Ilk
EXCLUSION OF WARRANTIES. THE PURCHASER AND SELLER AGREE THAT THE IMPLIED
WARRANTIES OF MERCHANTABILITY AND IFff TNESS FOR A PARTICULAR PURPOSE AND
ALL OTHER WARRANTIES EXPRESS OR IMPLIED AIDE EXCLUDED FROM THIS 7TRANSAC-
TI ON AMID SHALL N07 APPLY TO THE GOODS S®II.IID, PROVIDED IH OWEVER, :7THAT THIS
EXCILUSIION OF WARRANTIES, APPLIES ONLY TO SELLER AND 7T.ffH[A7T THE GOODS SOLD
PURSUANT TO THIS 7TRANSAi✓7TIDNI ARE OR MAY ICE SUBJECT 7T® THE WARRANTIES,
EXPRESS OR IMPLIED, GIVEN BY THE MANUFACTURER THEREOF.
Purchaser agrees to purchase the above described goods and to pay Atlas Restaurant Supply, Inc. (Seller) the
total price stated herein for the above described goods, including sales tax, in accordance with the Sale Terms.
Sale Terms are net cash seven (7) days after delivery, with interest thereon at the rate of one and one half per
cent (1!4 per month -on the unpaid total price, commencing seven (7) days delivery of the described goods
for each month or portion thereof during which an outstanding balance of the total price remains. Purchaser
assumes all risk of dafnages destruction to the goods upon delivery. Purchaser agrees, to- pay Seller's rea-
soriable attorney's fees and costs of collection of any amount not Paid when due: Purchaser agrees that no
return of the goods sold hereunder may be made to Seller without express*writ1ein approval of Seller and that
Seller may charge a reasonable stocking fee for all goods so returned.
SECURITY AGREEMENT. T. Purchaser hereby grants and 'conveys to Seller a security interest in and to 'the
described goods, and in and to the proceeds thereon, to secure the payment of Purchaser for the goods sold
hereunder. Purchaser authorizes Seller to execute on its behalf and file any financing statements deemed nec-
essary by Seller to perfect its security interest in said goods. Purchaser warrants that the goods will. be main
tained in good condition and repair. The failure to pay when due of any amount payable here under shall con
stitute a default under this agreement. Upon default, Seller have and may exercise all the rights and remedies
of a secured party under the Uniform Conunercial erode or any other applicable law.
Prescribed b'''ate Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
Morn, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
I\ Payee
Purchase Order No.
Q L>—ox Terms
7t e, 7 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
6A)D
ON ACCOUNT OF APPROPRIATION FOR
Z�9
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
'730 Y3U (oSO- Utz aS bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
20
i� �ig
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund
C 0 INDIANA RETAIL TAX EXEMPT PAGE
�Y II C armel CERTIFICATE NO.OQ3120155 002 0 1J�+ �J' LL PURCHASE ORDER NUMBER
t
FEDERAL EXCISE TAX EXEMPT
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 4997
PURCH,�SE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
A7
SHIP
'c',� J� SHIP
VENDOR !Z �w
TO 7 IV
CONFIRMATION BLANKET CONTRACT 1i PAYMENTTERMS FREIGHT
Jam-` 4.r f 0 �;g -5
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1,,2 7
10
14 3
rs+ n
o hm .a
Send invoice To
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE ISAN UNOBLIGATED BALANCE W
TH APPROPRIAT
I$ ION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID. (�i
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE L A 0," r?li.✓
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO
J 6 7 -7 CLERK- TREASURER
DOCUMENT CONTROL NO. A.. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.-
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PD# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except_.__,
20
Signature
Title
Cost distribution (edger classification if
claim paid motor vehicle highway fund